Pheochromocytoma - a tumor benign or malignant nature, which is composed of chromaffin cellsproducing catecholamines.In most cases, chromaffin cells are located in the adrenal medulla.So often speak of adrenal pheochromocytoma.But 10% of cases they are formed in paraganglia (neuroendocrine organs), sympathetic ganglia, and other organs.Cells which are located in the adrenal medulla produce adrenaline and noradrenaline.Those that are located in other organs, only produce noradrenaline.

in normal adrenal glands produce hormones with which to maintain a stable blood pressure is regulated by the body's metabolism, the balance of male and female sex hormones.With the development of adrenal pheochromocytoma tumor appeared contributes to uncontrolled development of one of the hormones.As a result, organism there are pathological changes that can lead to serious consequences.

Causes of pheochromocytomas are not known.Most experts tend to the hereditary nature of this disease.

symptoms of pheochromocytoma

usually manifests more of the symptoms of adrenal pheochromocytomas, tumors than other organs.

constant feature of this disease is high blood pressure (hypertension), which usually occurs with frequent hypertensive crises.During the crisis the patient sharply increased blood pressure, thus normalizing in mezhkrizovy period.A little less is a form of pheochromocytoma in which blood pressure is constantly increased and on the background of evolving crises.Sometimes the disease proceeds with consistently high blood pressure and without crises.

symptoms of pheochromocytoma during a hypertensive crisis are manifestations of disorders of the neuro-psychic nature of the exchange, the work of the circulatory system, gastrointestinal tract.The patient has multiple indications:

pale skin, chills, tremors;

anxiety, fear;

pain in the heart, behind the sternum;

headache, pale skin;

heart rhythm disturbances, heart palpitations;

nausea, vomiting, dry mouth;

sweating, increased body temperature.

Optionally, the occurrence of the above symptoms in a patient with pheochromocytoma, but in most cases there are many of them.

Hypertensive crisis fast starts and fast finishes.Blood pressure returned to normal, redness of the skin, excessive sweating may occur.After the attack, the patient feels weakness, general weakness.

reason attacks are most often hypothermia, sharp movements, physical and emotional stress, alcohol abuse, or taking certain medications.The patient may be one crisis several months or once every 10-15 days.Their duration is also different - from 2-3 minutes to 3 hours.

stable form of pheochromocytoma is characterized by consistently high blood pressure, frequent violations of kidney function, headache, fatigue, irritability, changes in the fundus.

There are symptoms of pheochromocytoma, which point to an increased metabolism and glucose dysregulation.These include weight loss, diarrhea, sweating, increased blood glucose concentration.

disease diagnosis

In the first stage of diagnosis of pheochromocytoma determine the presence of catecholamines in adrenal tissue, bronchial and urinary system.To do this, use the method for silvering Grimeliusu and Gamperlyu-Masson.

also laboratory diagnosis of pheochromocytoma includes determining the patient in daily urine values ​​of catecholamine secretion.

To clarify the diagnosis is very important to study the features of the patient's blood pressure fluctuations.A characteristic feature of this disease is to reduce the volumes of blood vessels and increase the overall resistance.

important step in the diagnosis of pheochromocytoma is to study the cardiac activity of the patient.This pathology often causes a persistent rhythm of the heart and the emergence of cardiomyopathy (an inflammatory disease of the heart muscle).

effectively in the diagnosis of pheochromocytoma the study using CT and MRI.This ultrasound examination is informative only if the tumor size more than two centimeters.

treatment of pheochromocytoma

most effective way to treat adrenal pheochromocytoma - surgery to remove the tumor.But there are cases where surgery is not possible to temporarily or completely impossible.This is related to high blood pressure, poor cardiac and vascular condition.In this case, the patient is prescribed medication, which usually takes several days.

When medical treatment of pheochromocytoma the patient most of the time have to spend in bed in half upright position.To normalize blood pressure him to prescribe alpha-blockers (Tropafen, phentolamine, phenoxybenzamine).During this period of preoperative therapy is very important to prevent dehydration of the patient.

method of surgical treatment of pheochromocytoma is selected depending on the characteristics of the tumor process.The most commonly used methods are extraperitoneal, transthoracic, transbryushinny and combined.

Forecast surgical treatment of a single tumor rather favorable.Recurrence of the disease is only in 12-15% of patients.

When multiple tumors, pheochromocytoma is most effective removal of all tumors.However, such operations have a high risk an unfavorable outcome.So often removed only part of the tumor, or spend their removal in several stages.

In cases where surgery is absolutely contraindicated, conducted therapy drugs that facilitate the patient's condition and reduce the symptoms of the disease.Treatment is carried out pheochromocytoma drug Alfa metilparatirozin, able to inhibit the production of catecholamines.To normalize calcium metabolism, reduce the pressure, vasodilation, or the patient is prescribed Nifedilin Nikardilin.

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